Tutoring Support for FUSD Distance Learning – Sign UP

Name of your Group*

Where is Your Group Located?*

Brief Description of your Group*

Website (if any)

What grade levels do you teach?*

What subject(s) do you teach for each grade level?*

(please be very specific)

Are the materials that you use aligned with the FUSD textbooks/curriculum?*

How many teachers do you have for each subject?*

Example: Algebra 1 - 3 teachers Spanish - 2 teachers World History - 1 teacher

Do you have a logo and/or flyer that you would like to attach with this application? Please send it to admin@fuss4schools.org

Yes
No
Maybe Later

Person in Charge of Virtual Tutoring Program

Name of Applicant*

First Last

Applicant's Email*

Applicant's Phone*

Applicant's position/title*

If applicant is a student, what high school do you attend? Grade Level?*

Example: Washington High School - 9th Grade

Name of Parent or Guardian (if the applicant is a minor)

First Last

Parent / Guardian Email

Parent / Guardian Phone

Consent*

I, on behalf my group, consent to assume all risks and release FUSS of all liability.

I, ON BEHALF OF MY ENTIRE GROUP, HEREBY ASSUME ALL OF THE RISKS OF ORGANIZING/HOSTING/CONDUCTING OUR GROUP’S EVENT/WORKSHOPS/ACTIVITIES SUPPORTED/PROMOTED/SPONSORED BY FREMONT UNIFIED STUDENT STORE (FUSS), including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

In consideration of this proposal to have the support/promotion/sponsorship of Fremont Unified Student Store (FUSS), I hereby take action for myself, my entire group, our executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I ON BEHALF OF MY GROUP, WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my/our death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me/us including my/our traveling to and from the activities and/or events, THE FOLLOWING ENTITIES OR PERSONS: Fremont Unified Student Store (FUSS), and/or their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, activity or event volunteers;

(B) I AND MY GROUP INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims, whether caused by the negligence of release or otherwise.

I on behalf of my group acknowledge that Fremont Unified Student Store (FUSS) and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity.

The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY ON BEHALF OF MY GROUP THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON BEHALF OF MY GROUP OF OUR OWN FREE WILL.

Virtual Tutoring Group Application

Person in Charge of Virtual Tutoring Program